| NPI | 1639470743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE GRAVLEY Owner/President 702-212-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV PY0381) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |